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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486803967
Report Date: 09/03/2025
Date Signed: 09/03/2025 02:03:56 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/20/2025 and conducted by Evaluator Ethel Contreras
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20250820144736
FACILITY NAME:LONGSPUR MANORFACILITY NUMBER:
486803967
ADMINISTRATOR:ANGELES, JANNEFACILITY TYPE:
735
ADDRESS:1107 LONGSPUR DRTELEPHONE:
(415) 939-4491
CITY:SUISUN CITYSTATE: CAZIP CODE:
94585
CAPACITY:4CENSUS: 4DATE:
09/03/2025
UNANNOUNCEDTIME BEGAN:
12:16 PM
MET WITH:Romel Lopez- Designee TIME COMPLETED:
02:30 PM
ALLEGATION(S):
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lack of supervision
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Ethel Contreras and Marisol Cuadra arrived unannounced to conduct a complaint investigation and delivered findings regarding the allegation listed above and met with Romel Lopez.

The Department received an allegation of Lack of Supervision. Per Reporting Party, on August 11, 2025, client (C1) expressed to reporting party that they felt uncomfortable regarding interactions with another client (C2), C1 stated that on the previous day both clients engaged in several phone conversations of a sexual nature. They agreed to meet at a movie theater on Sunday, August 10, 2025. During the outing with the facility staff, C1 reported that C2 brought contraceptives, which made them feel uncomfortable. Despite this, C1 consented to accompany C2 to the theater restroom, where they engaged in mutual physical contact. C1 expressed that while they initially agreed, C1 felt uneasy due to fear of being caught by staff or security, then C1 requested to return to the movie, and C2 complied.
Continued to LIC9099-C....
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Ethel Contreras
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 21-AS-20250820144736
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: LONGSPUR MANOR
FACILITY NUMBER: 486803967
VISIT DATE: 09/03/2025
NARRATIVE
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Continued from LIC9099...
C1 further reported that during the movie, C2 reached into their shirt and down their pants without their consent. C1 stated that they did not stop them due to difficulty asserting boundaries and saying no, but C1 informed their parents and Longspur house staff (S1) about the incident. C1 also reported that S1 from Longspur had left them unattended at the theater and had done so on previous occasions.

Based on records review, C1’s physician report dated 10/8/24 indicates that C1 does not have the capacity for self-care, including been supervised by staff at all times or direct family, which it was confirmed in C1’s admission agreement dated 9/20/21, where the facility agreed to 24-hour personal care, supervision and assistance as well as transportation to social activities. Furthermore, C1’s individual program plan dated 9/18/24 determines that the facility will be always providing supervision to ensure the resident’s safety and well-being.

LPAs obtained written communication from meeting conducted on 8/19/25 at approximately 4:20pm with C1, S1, placement agency service coordinator and C1’s responsible party, where it was discussed that S1 accompanied C1 to the movies following their one on one (1:1) care plan, movie ticket was provided. Per incident report, C1 requested privacy during the outing, S1 remained within proximity, both clients went to use the restroom twice during the movie and S1 remained at their seat located three rows behind them where there was no direct supervision provided to C1. In the meeting there were agreements made to ensure the future safety of C1. Based on interviews conducted with C1, it revealed that S1 was not present to assist them when needed. Interviews conducted with S1 revealed that S1 was present during the outing, but did not accompany C1 on both occasions when both clients went to use the restroom because S1 did not see C2 going to the restroom and C1 appeared to enjoy the date and there were no signs of distress or fear. According to interviews conducted with C1’s responsible party confirmed the above information.

The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6, Chapter 8), is cited on the attached LIC 9099D.

Appeal Rights Given.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Ethel Contreras
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 21-AS-20250820144736
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: LONGSPUR MANOR
FACILITY NUMBER: 486803967
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/03/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/03/2025
Section Cited
CCR
80078(a)
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80078 Responsibility for Providing Care and Supervision (a)The licensee shall provide care and supervision as necessary to meet the client's needs.
This requirement is not met as evidenced by:
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Facility has conducted a meeting with pertinent parties clarifying the supervision requirements on 8/19/2025. Facility to submit proof of training no later than 9/04/2025 to clear deficiency.
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Based on record reviews and interviews with pertinent parties, it was revealed that client was unsupervised when both clients went to use the restroom twice during a movie outing despite staff 1:1 supervision expectation. This is an immediate risk to health and safety of clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Ethel Contreras
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
LIC9099 (FAS) - (06/04)
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